Senate OKs $9-Billion Shift of Medicaid to States

Health care: Governors praise the effort to shore up services that have been hurt by budget woes. The House has not passed a similar plan.

WASHINGTON — The Senate passed a measure Thursday that would send $9 billion in Medicaid help to states struggling to care for the poor amid shrinking budgets.

Governors, who had pressed for the proposal, praised the 75-24 vote.

"Many states continue to face budget shortfalls and face the prospect of instituting significant cuts in health care and social services to curb expenditures," said Kentucky Gov. Paul E. Patton, as chairman of the National Governors Assn.

The measure "is an important first step in helping states maintain service levels during the continuing fiscal crisis."

Idaho Gov. Dirk Kempthorne, the association's vice chairman, said the Senate action "ensures that many low-income families will be protected from drastic cuts."

The measure would give states $6 billion in additional federal matching funds and $3 billion in grants to help them pay for child care and other social service programs.

The Medicaid provision is attached to an overall bill to ease access to generic drugs. Lawmakers continued to work Thursday on a compromise Medicare drug benefit proposal that they would also like to add to the generic drug bill.

The House has not passed a similar plan.

The Medicaid measure brought cooperation among Senate Republicans and Democrats, getting far more than the 60 votes needed for passage.

"This is not a bailout," said Sen. John D. "Jay" Rockefeller IV (D-W.Va.), a sponsor of the plan. "I would say it's very important for the states to be healthy."

Medicaid was created to provide health care to people on welfare and is financed by a combination of federal and state money. On average, Washington pays 57%.

But with health-care spending increasing and the troubled economy forcing tight budgets, states have been sounding the alarm about Medicaid, one of the fastest-growing portions of state budgets.

More than 40 states suffered budget shortfalls of $40 billion to $50 billion in the last fiscal year. Medicaid spending increased 13% and now constitutes 20% of state budgets.

Opponents had argued that the plan amounts to a giveback for states.

"We're broke and we don't act like it," said Sen. Phil Gramm (R-Texas). "A year ago we had a surplus. Today we have a $165-billion deficit, and we're still spending like drunken sailors."